title: Gallstone ileus: surgical strategies and clinical outcome.
abstract: OBJECTIVE
  Gallstone ileus is a rare cause of intestinal obstruction affecting mainly the elderly. This study aimed to analyze the surgical treatments and outcome of the disease.
  
  
  METHODS
  We present a retrospective study of 13 patients diagnosed with gallstone ileus from January 2000 to December 2005 in our hospital and a review of the published literature.
  
  
  RESULTS
  Three men and 10 women participated in the study, with a mean age of 74.3 (range: 63-85). The mean duration of symptoms was 6 days (range 2-14). A pre operative diagnosis was made in 10 patients. The mean delay in diagnosis was 3.5 days (range 1-10). Ten patients had an enterolithotomy (E) and three patients had a one-stage procedure comprising enterolithotomy, cholecystectomy and fistula repair (EC). There was no postoperative mortality in either group. The mean postoperative hospital stay for group E was 14 (range 6-31) days and for group EC was 19 (range: 5-28) days. Twelve patients were alive at the time of review. One patient from group E died of unrelated causes after three years. One patient in group E developed cholangitis but no surgical intervention was required on case note review over a mean postoperative period of 3.4 years.
  
  
  CONCLUSIONS
  E alone is best suited in all elderly gallstone ileus patients with significant comorbidities. A one-stage procedure (EC) should be reserved for young, fit and low risk patients.
authors.affiliation: Department of Surgery, University of Aberdeen, Aberdeen, UK. mgirivasan@hotmail.com
authors.forename: Girivasan
authors.initials: G
authors.lastname: Muthukumarasamy
authors.forename: Siva P
authors.initials: SP
authors.lastname: Venkata
authors.forename: Irshad A
authors.initials: IA
authors.lastname: Shaikh
authors.forename: Bhaskar K
authors.initials: BK
authors.lastname: Somani
authors.forename: Rajan
authors.initials: R
authors.lastname: Ravindran
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D042882:Gallstones / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged